Cervical Dystonia Mimics: A Case Series and Review of the
                        Literature

Raju, S. P. Govinda; Ravi, Amogh; Prashanth, L.K.

doi:10.5334/tohm.465

Cited by 4 publications

(1 citation statement)

References 41 publications

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“…They can be classified into musculoskeletal disorders without coexisting neurologic abnormalities (GS, congenital vertebral anomalies such as Klippel-Feil syndrome, congenital muscular torticollis [a rare congenital musculoskeletal disorder with unilateral shortening of SCM]), lesions of the posterior fossa and cervical cord (tumors/cysts), primary neurologic conditions (trochlear/ abducens palsy and vestibulopathy), benign paroxysmal torticollis, infections like retropharyngeal abscess, and Sandifer syndrome (SS). 1,4 In SS, it is thought that the tilted head position probably yields relief from the discomfort caused by acid reflux. Abrupt onset, severe pain, resistance to passive neck movements, fixed posture present equally at rest and action, absence of sensory trick, and persistence in sleep favor pseudodystonia.…”

Section: Discussionmentioning

confidence: 99%

Pearls & Oy-sters: Grisel Syndrome Presenting as Pseudodystonia: A Twist in the Neck

Cherian

2022

Neurology

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Pseudodystonia is a term that describes abnormal postures, repetitive movements, or both, where clinical analysis, imaging, laboratory or electrophysiological investigations indicate that these movements are not consistent with dystonia. Grisel’s syndrome (GS), characterised by rotatory subluxation of the atlantoaxial joint (AAJ) due to non-traumatic causes, is a cause of pseudodystonia. GS is seen in children less than 12 years of age, and should be suspected in patients with acute onset of painful torticollis. We report two girls, aged 9 and 6 years, who developed painful torticollis following upper respiratory tract (URT) infection. They were thought to have cervical dystonia and referred to a movement disorder specialist for botulinum neurotoxin therapy (BoNT). Magnetic resonance imaging (MRI) of the cervical spine showed type I and type II rotary AAJ subluxation respectively, which confirmed the diagnosis of GS. Short tau inversion recovery (STIR) hyperintensity was noted suggesting AAJ edema without any bone erosion or cord compression. Abruptness of onset, presence of severe pain, resistance to passive neck movements, fixed postures present equally in rest and action, absence of sensory trick, and persistence in sleep favor pseudodystonia. Both subjects improved with conservative treatment, which included temporary immobilization of the cervical spine and anti-inflammatory drugs. Early identification and treatment is imperative to avoid neurological complications, like high cervical compressive myelopathy, which can lead to quadriplegia and respiratory distress. Prominent sternocleidomastoid (SCM) contraction ipsilateral to the rotated chin helps to clinically identify GS.

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Section: Discussionmentioning

confidence: 99%

Pearls & Oy-sters: Grisel Syndrome Presenting as Pseudodystonia: A Twist in the Neck

Cherian

2022

Neurology

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Long-term efficacy with deep brain stimulation of the globus pallidus internus in cervical dystonia: a retrospective monocentric study

Jacksch

Zeuner

Helmers

et al. 2022

Neurol. Res. Pract.

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Background Cervical dystonia (CD) is characterized by involuntary contractions of the cervical muscles. Data on long-term effectiveness of deep brain stimulation (DBS) are rare. The aim of this study was to evaluate the longitudinal ten years treatment efficacy of DBS in the globus pallidus internus (GPI). Methods A retrospective single-center data analysis was performed on patients with idiopathic CD, who were treated with GPI DBS for at least 10 years. TWSTR severity score and individual sub-items were compared between pre and post DBS surgery (n = 15) over time. Results There was a significant and persistent positive effect regarding the severity of TWSTRS between the conditions immediately before and 1, 5, and 10 years after establishment of GPI DBS (mean difference: 6.6–7 ± 1.6). Patients with increasing CD complexity showed a poorer response to established treatment forms, such as injection of botulinum toxin and were thus DBS candidates. Especially a predominant torticollis was significantly improved by DBS. Conclusion GPI DBS is an effective procedure especially in severely affected patients with a positive 10-year outcome. It should be considered in more complex CD-forms or predominant torticollis.

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Methods of Brain Research in the Cervical Dystonia

Ragimova,

Feurra

2023

Zhurnal Vysshei Nervnoi Deyatelnosti Imeni I.P. Pavlova

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The review is based on 149 foreign and Russian articles. The features of the brain functioning in cervical dystonia (CD) through the prism of modern technologies are reviewed. CD is hard to diagnose currently. CD is one of the promising areas not only in the clinical paradigm. In the future, CD can become an interesting model for studying the features of the balance of excitation/inhibition in brain neurons with the use of modern technologies. Using CD as a model of specific changes in function connections of brain regions, it would be possible to extrapolate the results to a healthy population and to the patients with other neurological or mental diseases.

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Cervical Dystonia Mimics: A Case Series and Review of the Literature

Cited by 4 publications

References 41 publications

Pearls & Oy-sters: Grisel Syndrome Presenting as Pseudodystonia: A Twist in the Neck

Pearls & Oy-sters: Grisel Syndrome Presenting as Pseudodystonia: A Twist in the Neck

Long-term efficacy with deep brain stimulation of the globus pallidus internus in cervical dystonia: a retrospective monocentric study

Methods of Brain Research in the Cervical Dystonia

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